• Yoshinori Tokushima, Yuta Sakanishi, Kou Nagae, Midori Tokushima, Masaki Tago, Motosuke Tomonaga, Tsuneaki Yoshioka, Masaki Hyakutake, Takashi Sugioka, and Shu-ichi Yamashita.
• Department of General Medicine, Saga University Hospital, Saga city, Japan.
• Am J Case Rep. 2014 Jan 1; 15: 312-6.

PatientMale, 23.Final DiagnosisThyroid storm.SymptomsDelirium • diarrhea • fever • hypertension • hyperventilation • tachycardia • weight loss.Medication-.Clinical Procedure-.SpecialtyEndocrinology and Metabolic.ObjectiveUnusual clinical course.BackgroundThe clinical presentation of thyroid storm includes fever, tachycardia, hypertension, and neurological abnormalities. It is a serious condition with a high mortality rate. Furthermore, some other complications affect the clinical course of thyroid storm. Although it is reported that prognosis is poor when thyroid storm is complicated by disseminated intravascular coagulation syndrome (DIC) and leukopenia, reports of such cases are rare.Case ReportA 23-year-old man presented with delirium, high pyrexia, diarrhea, and weight loss of 18 kg over 2 months. According to the criteria of Burch and Wartofsky, he was diagnosed with thyroid storm on the basis of his symptom-complex and laboratory data that confirmed the presence of hyperthyroidism. Investigations also found leukopenia, thrombocytopenia, and disseminated intravascular coagulation, all of which are very rare complications of thyroid storm. We successfully treated him with combined therapy including anti-thyroid medication, despite leukopenia.ConclusionsEarly diagnosis and treatment are essential in ensuring a good outcome for patients with this rare combination of medical problems.

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